EP studies helpful in lumbar spinal stenosis prognosis

Blanka Micankova Adamova, Ph.D., of University Brno in the Czech Republic, and colleagues followed a group of 56 patients with clinically symptomatic mild-to-moderate LSS for seven years to identify predictors of clinical outcome that might one day assist in therapeutic selection.

The researchers identified electrophysiological parameters that were significantly associated with unsatisfactory clinical outcomes in this patient population. Specifically, patients with electromyography (EMG) signs of pluriradicular involvement were 3.72-fold more likely to have an unsatisfactory outcome (68.2 versus 32.3 percent). Additionally, those with an averaged soleus H-reflex amplitude of 2.8 mV or less were 2.87-fold more likely to have an unsatisfactory outcome (50.0 versus 14.7 percent).

"Satisfactory outcome (unchanged or better clinical status) appeared in 61 percent of patients with mild-to-moderate LSS after seven-year follow-up," the authors write. "As electrophysiological parameters showed some prognostic value in patients for LSS, especially those of pluriradicular involvement and the parameters of soleus H-reflex, we recommend the use of needle EMG and conduction studies as a standard examination in patients with LSS."

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